account.covermymeds.com Open in urlscan Pro
66.97.160.55  Public Scan

Form analysis
1 forms found in the DOM

POST /forgot

<form id="forgot-form" action="/forgot" accept-charset="UTF-8" method="post"><input type="hidden" name="authenticity_token" value="vY9gvmGYilNNgJHGp0p-v0RF1KF8fG2C_VqLy4x7-RkBsPtsNEMSzvofvUILBmvaZX3ZYlmN2LFbkCPeoEjAog" autocomplete="off">
  <div class="js-field-wrapper mdc-text-field style--width-100 mdc-text-field--upgraded mdc-text-field--focused" data-mdc-auto-init="MDCTextField">
    <input type="text" name="email" id="email" value="" class="mdc-text-field__input" autofocus="autofocus" data-validate="[&quot;required&quot;,&quot;isEmail&quot;]" data-name="Your email">
    <label class="mdc-floating-label mdc-floating-label--float-above" for="email">Email</label>
    <div class="mdc-line-ripple mdc-line-ripple--active"></div>
  </div>
  <input type="submit" name="commit" value="Recover" id="forgot-button" class="mdc-button mdc-button--raised secondary-filled-button style--width-100 spacer__top--medium" data-disable-with="Recover">
</form>

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